Histology of saphenous veins after treatment with the ClariVein® device – an ex-vivo experiment
Article first published online: 26 FEB 2013
© The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin
JDDG: Journal der Deutschen Dermatologischen Gesellschaft
Volume 11, Issue 4, pages 348–352, April 2013
How to Cite
Kendler, M., Averbeck, M., Simon, J. C. and Ziemer, M. (2013), Histology of saphenous veins after treatment with the ClariVein® device – an ex-vivo experiment. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 11: 348–352. doi: 10.1111/ddg.12022
- Issue published online: 10 APR 2013
- Article first published online: 26 FEB 2013
- Manuscript Accepted: 15 NOV 2012
- Manuscript Received: 9 NOV 2012
Endovenous treatment modalities are used increasingly to treat varicose veins. The ClariVein® catheter is a new endoluminal mechanico-chemical obliteration technique which can be used without tumescent anesthesia. It is still unclear what changes the mechanical tip of the catheter has on the walls of the vein.
Patients and methods
Five great saphenous vein specimens were obtained atraumatically by crossectomy. Then the veins were treated ex vivo with the ClariVein® catheter without sclerotherapy. The activated catheter rotating tip (3 500 U/min) was steadily withdrawn at 1–2 mm per second. Subsequently, histological and immunohistochemical investigations of treated (cv) and untreated specimens (plain) were performed. A 4-point score was calculated to compare the results.
The mechanical part of the catheter caused a subtle incomplete destruction of the endothelium (endothelium cv: 2.2 vs. plain: 1, p = 0.04). Changes in the media or adventitia were not seen. Immunohistochemical presentation of the endothelium of the intima was demonstrated with antibodies against CD31 (cv: 3.4 vs. plain: 2.8), CD34 (cv: 3.8 vs. plain: 3.2) and factor VIII (cv: 2.2 vs. plain: 1, p = 0,004).
The mechanical part of the ClariVein® catheter caused a subtle incomplete destruction of endothelium, which was confirmed histologically and immunohistochemically. The reduced expression of factor VIII in the treated vein could be caused by the release of preformed factor VIII granules due to the minimal mechanical irritation.